[P3-101] Prognostic value of continuous electroencephalography in children underwent therapeutic hypothermia after cardiac arrest: A pilot study
[Objective]To determine the prognostic value of continuous electroencephalography(EEG) in children underwent therapeutic hypothermia after cardiac arrest.
[Method] We retrospective reviewed medical records and continuous EEG of all patients underwent therapeutic hypothermia after cardiac arrest from November 2013 to September 2016. Demographic, clinical data and immediate complication were collected. Characteristics of continuous EEG including EEG background, time to normal trace (TTNT) and Electrographic seizure were reviewed by investigators. Cerebral performance category scale at 6 months follow up were evaluated and divided into good (grade 1-2) and poor (grade3-5) outcome groups.
[Result] Five patients were included (two boys and three girls) with mean age of 2.5years (range15-87months). Four patients (80%) presented with cardiac arrest from near-drowning and one patient with underlying acute lymphocytic leukemia developed cardiac arrest inside the hospital. Initial EKG rhythm was asystole in 3 patients (60%), pulseless activity in 1 patient (20%) and normal sinus rhythm after cardiopulmonary resuscitation for 3 minutes in 1 patient (20%). One patient (20%) who had EEG reactivity and TTNT within 2.5 hours had good neurological outcome (CPC1). Four patients (80%) with absent EEG reactivity had poor neurological outcome (CPC4 ,5 in 3 and 1 children respectively). Three patients from the second group have electrographic seizures. Two out of three patients progressed to status epilepticus. Three out of four patients in the second group had complications as the followings: pneumonia, bleeding and pancreatitis.
[conclusion] An early TTNT and EEG reactivity have prognostic value of good neurological outcome. Seizure, status epilepticus and complication may predict poor neurological outcome.
[Method] We retrospective reviewed medical records and continuous EEG of all patients underwent therapeutic hypothermia after cardiac arrest from November 2013 to September 2016. Demographic, clinical data and immediate complication were collected. Characteristics of continuous EEG including EEG background, time to normal trace (TTNT) and Electrographic seizure were reviewed by investigators. Cerebral performance category scale at 6 months follow up were evaluated and divided into good (grade 1-2) and poor (grade3-5) outcome groups.
[Result] Five patients were included (two boys and three girls) with mean age of 2.5years (range15-87months). Four patients (80%) presented with cardiac arrest from near-drowning and one patient with underlying acute lymphocytic leukemia developed cardiac arrest inside the hospital. Initial EKG rhythm was asystole in 3 patients (60%), pulseless activity in 1 patient (20%) and normal sinus rhythm after cardiopulmonary resuscitation for 3 minutes in 1 patient (20%). One patient (20%) who had EEG reactivity and TTNT within 2.5 hours had good neurological outcome (CPC1). Four patients (80%) with absent EEG reactivity had poor neurological outcome (CPC4 ,5 in 3 and 1 children respectively). Three patients from the second group have electrographic seizures. Two out of three patients progressed to status epilepticus. Three out of four patients in the second group had complications as the followings: pneumonia, bleeding and pancreatitis.
[conclusion] An early TTNT and EEG reactivity have prognostic value of good neurological outcome. Seizure, status epilepticus and complication may predict poor neurological outcome.